构建和外部验证一个诺莫格拉姆模型,用于预测内镜下膜剖析后食道狭窄的风险:一个多中心病例对照研究
Zhao Mu1,2, Xiao Tang3, Jingting Wang4
1Department of Gastroenterology, The Affiliated Hospital of North Sichuan Medical College, Sichuan, China.
BMC gastroenterology
|July 1, 2023
概括
这项研究确定了内镜下膜解剖 (ESD) 后食道狭窄的关键风险因素. 开发并验证了一种预测性诺莫格拉姆模型,在评估ESD患者的狭窄风险方面显示出高准确性.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医学统计 医学统计
背景情况:
- 食道狭窄是内镜下粘膜切割 (ESD) 后的常见并发症.
- 确定食道狭窄的预测因素对于患者管理至关重要.
- 现有的模型可能不完全结合生活方式因素或外部验证.
研究的目的:
- 调查ESD后食道狭窄的独立风险因素.
- 开发和验证一个诺莫格拉姆模型来预测食道狭窄风险.
- 提供指导临床实践和减少狭窄发生率的工具.
主要方法:
- 追溯收集ESD患者的临床数据和生活习惯.
- 使用两家医院的数据建立了开发和验证小组.
- 单变量和多变量逻辑回归分析以确定风险因素并构建名图.
- 使用C指数,ROC曲线和校准图表进行内部和外部验证.
主要成果:
- 年龄,饮用水温度,中性粒细胞-淋巴细胞比率,粘膜缺陷程度,切除的粘膜直径和侵入深度是显著的风险因素.
- 诺米图表显示出高预测准确度,C指数为0.925 (发展) 和0.861 (验证).
- ROC曲线和校准图表证实了预测和观察结果之间的良好的区别和一致性.
结论:
- 一个经过验证的诺莫格拉姆模型准确地预测了ESD后的食道狭窄风险.
- 该模型结合了临床和生活方式因素来进行全面的风险评估.
- 这种工具可以帮助临床医生预防和管理ESD后食道狭窄.
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